Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA): 2020 Guideline on Diagnosis and Management of Babesiosis.

The purpose of this guideline is to provide evidence-based guidance for the most effective strategies for the diagnosis and management of babesiosis. The diagnosis and treatment of co-infection with babesiosis and Lyme disease will be addressed in a separate Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR) guideline [1]. Recommendations for the diagnosis and treatment of human granulocytic anaplasmosis can be found in the recent rickettsial disease guideline developed by the Centers for Disease Control and Prevention [2].

Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease.

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines.

Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease.

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines.

Clinical Practice Guidelines by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology: 2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme Disease.

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines.

Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA): 2020 Guideline on Diagnosis and Management of Babesiosis.

The purpose of this guideline is to provide evidence-based guidance for the most effective strategies for the diagnosis and management of babesiosis. The diagnosis and treatment of co-infection with babesiosis and Lyme disease will be addressed in a separate Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR) guideline [1]. Recommendations for the diagnosis and treatment of human granulocytic anaplasmosis can be found in the recent rickettsial disease guideline developed by the Centers for Disease Control and Prevention [2].

Blood Viral Load in Symptomatic Congenital Cytomegalovirus Infection.

Background: Viral loads (VLs) frequently are followed during treatment of symptomatic congenital cytomegalovirus disease, but their predictive value is unclear.

Methods: Post hoc analysis of 2 antiviral studies was performed. Seventy-three subjects were treated for 6 weeks and 47 subjects were treated for 6 months.

A Randomized, Double-Blind, Placebo-Controlled Trial of Pleconaril for the Treatment of Neonates With Enterovirus Sepsis.

Background: Neonatal enterovirus sepsis has high mortality. Antiviral therapy is not available.

Methods: Neonates with suspected enterovirus sepsis (hepatitis, coagulopathy, and/or myocarditis) with onset at ≤15 days of life were randomized 2:1 to receive oral pleconaril or placebo for 7 days.

Lyme disease in children.

The diagnosis and management of Lyme disease in children is similar to that in adults with a few clinically relevant exceptions. The use of doxycycline as an initial empiric choice is to be avoided for children 8 years old and younger. Children may present with insidious onset of elevated intracranial pressure during acute disseminated Lyme disease; prompt diagnosis and treatment of this condition is important to prevent loss of vision.

Pertussis: still a cause of death, seven decades into vaccination.

Purpose Of Review: We review the resurgence of pertussis, including recent trends in epidemiology and reasons for the resurgence, as well as updated vaccination schedules and recommendations.

Recent Findings: There has been a resurgence of pertussis in recent decades, in the United States and worldwide. This is a preventable cause of hospitalizations and deaths, especially among the infant population.

Clinical approach to known and emerging tick-borne infections other than Lyme disease.

Purpose Of Review: We review latest developments in knowledge of established and emerging tick-borne infections in the United States other than Lyme borreliosis, emphasizing a clinical and geographic approach to diagnosis and management.

Recent Findings: The incidence of tick-borne diseases in the United States has increased. New tick-borne diseases have emerged and will likely continue to be identified.

Oseltamivir pharmacokinetics, dosing, and resistance among children aged <2 years with influenza.

Background: Children <2 years of age are at high risk of influenza-related mortality and morbidity. However, the appropriate dose of oseltamivir for children <2 years of age is unknown.

Methods: The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group evaluated oseltamivir in infants aged <2 years in an age-de-escalation, adaptive design with a targeted systemic exposure.

Current challenges in the diagnosis and management of fever.

Purpose Of Review: We review recommendations from recent publications on the management of fever with antipyretics, the classification and diagnosis of fevers of unknown origin (FUO), and the evaluation of fever in infants under 90 days of age.

Recent Findings: Anxiety about fever persists in the population, while the toxicity of antipyretics is an increasing concern. The numerous opportunities for overdosing with antipyretics have been emphasized by the American Academy of Pediatrics (AAP).

Update on the management of simple febrile seizures: emphasis on minimal intervention.

Purpose Of Review: We summarize recent clinical reviews and updated American Academy of Pediatrics (AAP) clinical guidelines for the management of children with simple febrile seizures.

Recent Findings: There has been a dramatic reduction in the incidence of bacterial meningitis and of occult bacteremia since the advent of Haemophilus influenzae type b and Streptococcus pneumoniae immunization. This has made routine laboratory evaluation for these bacterial infections unnecessary in a fully immunized, well appearing child who presents with a simple febrile seizure.

Antiscience and ethical concerns associated with advocacy of Lyme disease.

Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science.

Comparison of the clinical features of children hospitalized with pandemic 2009 A:H1N1 and seasonal influenza.

Introduction: We compared the demographics, clinical presentation, course and outcome of children hospitalized with pandemic A:H1N1 and seasonal influenza.

Methods: Sixty seven patients hospitalized from April 1st through August 31st 2009 with pandemic A:H1N1 influenza were enrolled. Two seasonal influenza cohorts were identified: 38 inpatients from January 1st 2004 through March 31st 2009, diagnosed by viral culture or direct fluorescent antibody testing; and 42 inpatients from January 1st 2007 through December 31st 2008 diagnosed via a rapid test.

Scientific evidence and best patient care practices should guide the ethics of Lyme disease activism.

Johnson and Stricker published an opinion piece in the Journal of Medical Ethics presenting their perspective on the 2008 agreement between the Infectious Diseases Society of America (IDSA) and the Connecticut Attorney General with regard to the 2006 IDSA treatment guideline for Lyme disease. Their writings indicate that these authors hold unconventional views of a relatively common tick-transmitted bacterial infection caused by the spirochete Borrelia burgdorferi. Therefore, it should come as no surprise that their opinions would clash with the IDSA's evidence-based guidelines for the diagnosis and treatment of Lyme disease.

What we have learned about Lyme borreliosis from studies in children.

Although pediatric Lyme borreliosis (LB) need not be a separate nosological entity, there are clinically important differences in presentation, antibiotic regimens and outcomes in children, which provide lessons that can be extrapolated to the disease as it affects adults. A large proportion of the worldwide data is obtained from children. The aim of this presentation is not to present an exhaustive review of the pediatric literature, but to review a selection of pediatric studies that have made a significant contribution to our body of knowledge in Lyme borreliosis.

Prevalence of coronary artery lesions on the initial echocardiogram in Kawasaki syndrome.

Objectives: To determine whether coronary artery lesions (ectasia and aneurysm) are commonly observed on the initial echocardiogram of patients with acute Kawasaki syndrome, whether coronary artery ectasia and/or aneurysms occur more frequently in patients with incomplete Kawasaki syndrome than in those patients with complete findings, and whether earlier diagnosis and treatment of Kawasaki syndrome are associated with less frequent occurrence of coronary artery ectasia and/or aneurysm.

Design: A retrospective medical record review.

Setting: A tertiary care pediatric hospital.

Hypoglycorrhachia in Lyme meningitis.

We describe a previously healthy 11-year-old girl with acute neuroborreliosis, who presented with left sixth cranial nerve palsy, elevated intracranial pressure, markedly elevated cerebrospinal fluid leukocyte count and protein concentration and severe hypoglycorrhachia. These laboratory findings are atypical for neuroborreliosis.

Prolonged candidemia in infants following surgery for congenital heart disease.

Objectives: To describe a group of infants with complex congenital heart disease (CCHD) who had candidemia postoperatively and to perform a case-control study of risk factors.

Design: Descriptive and case-control study.

Setting: Tertiary-care medical centers.

Effective retrieval of Lyme disease information on the Web.

The spirochetal infection Lyme disease, although now usually easily diagnosed and treated, has acquired an aura of ambiguity for many laypersons and medical professionals. The existence of controversy makes it difficult for infectious diseases physicians and scientists to readily obtain accurate information on Lyme disease by casually browsing the World Wide Web. Informative and current Web sites on the diagnosis, epidemiology, treatment, and prevention of Lyme disease can be found on-line, as can clear images of its clinical variants and of ticks.